Laserfiche WebLink
, CHECK OFF LIST FOR ISSUA�.�`CE OF PER11�II'I'S <br /> _ FOR OFFICE USE ONLY . � , <br /> ADDRESS OR LEGAL: �� ��r g��- <br /> PID: <br /> DESCRIPT'ION OF WORK: - <br /> . <br /> ZO�G REVIEti�BY: DATEAPPROVED: � t - 3 -v� <br /> BUILDI�YG REVIE�BY: . DATE APPROYID; � �_� , o J . <br /> FEES TO BE C�GED: Misc. Fees Calculated By: <br /> pERNIIT Yes ✓' No :. <br /> PLAN REVIEW Yes v No SEWER COVNECTTON <br /> STATE SURCHARGE Yes �/ No WATERCONNECTION <br /> INV�ESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION � <br /> Number of SAC�Units OTHER (specify) <br /> ZO\Zr'G CHECK LIST zoain,Districc: 22-\� . <br /> Fire Department: (�r�G (A�� Post Office: (�n�fo MC.0 School District: t�(Zb�td • <br /> LotArea: Sq.ft. a3b.(�ZS Acres •4�`{ � Widch 1A�-!�'To�(h� Depth <br /> Surve;Sub�itted: Yes_ (� No Date of Survey: g�Z -� <br /> Proposed Setbacks: � <br /> . , <br /> Front(La.ke): l 23 Ri�ht Side: ��c� ` <br /> Rear(Street): 5 Z� Left Side: Iv �+'A <br /> Adjacent Scructures: �4-n-tia c..�+e� Wetland: N!'t- • <br /> Buil�in; Heiaht: Def. H�t. p,t,c Peal:Hgt. 0�ti- <br /> Loc Coverage: <br /> Grading: Staff Approval Date: �' By: Council Approval Date: <br /> Septic: Staff Approval Date: -- By: <br /> Zoain;File: 1# 2-��v Resolucion: � � Resolution Date: _ . <br /> Shoreland District: U.pS <br /> Av�. Setback: �v1� Bluff Setback: ._�,__�(� I.ot Coven�e: <br /> E���, Proposed <br /> 0 <br /> Hardcover: 0-15' ---- . <br /> 75-250' _---- <br /> 250-500' -----.— <br /> 500-1000' <br /> Hazdcover Variance Required: Yes No Date of Council Approval: <br /> REI�IARKS(in house): <br /> 7 <br />